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Optimise your biomarkers for peak performance

Understanding your body’s key biomarkers and their response to stress can safeguard you against overtraining syndrome and enable you to optimise your training regime.

As an endurance athlete, you can optimise your performance by analysing and fine tuning key metabolic markers. There are lots of conflicting viewpoints out there on what exactly you need to test and that’s why we’ve designed this panel of blood tests to keep things simple, insightful and actionable. This panel includes a cortisol test.

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Our Endurance Check measures key drivers of performance including your metabolic hormone function (including a cortisol test), levels of inflammation in the body, muscle damage, oxygen carrying capacity and bone health. We also test the function of your body’s essential organs to ensure you’re building on a solid foundation.

What we test

Hormone Panel

No matter what your fitness goals are, one of the main determinants of whether you will reach them is your hormonal status. This hormone test measures the key hormones that must be in balance and play an important role in regulating sexual health, fertility and athletic performance.

This hormone test measures:

Testosterone is an anabolic hormone responsible for bone and muscle strength, as well as mood, energy and sexual function.

Most testosterone is strongly bound to sex hormone binding globulin (SHBG). This test measures the proportion of unbound testosterone which is available to the body's tissues.

Sex Hormone Binding Globulin (SHBG) is a protein that binds tightly to testosterone and oestradiol. Changes in SHBG levels can affect the amount of hormone that is available to be used by the body's tissues.

Also known as Somatomedin C. IGF-1 is an indirect measure of the average amount of GH being produced by the body.

The principle active form of oestrogen in the body which has roles in gynecomastia, water/fat retention and hormone balance.

Levels of follicle stimulating hormone in men rise with age, but can also indicate testicular damage and reduced sperm production. Low levels of FSH are detected when men are not producing sperm.

Luteinising hormone is responsible for stimulating testosterone production and sperm generation. Raised LH can signal that the testes are not producing enough testosterone and is relevant when evaluating hypogonadism.

A hormone which is produced in the pituitary gland and plays a role in reproductive health. Raised levels in men can cause reduced sex drive, lack of energy, erectile dysfunction and fertility problems.

Progesterone has two major effects in men - it promotes testosterone production, and also modulates the effects of excessive oestrogen.

Adrenal Function

Two of the most important hormones that impact athletic performance are cortisol and DHEA, the long-lasting stress hormones produced by the adrenal glands. Cortisol has a catabolic effect which mobilises the body’s nutritional resources for fuel. DHEA has an opposing anabolic effect and coverts food into living tissue. In order to achieve your fitness goals cortisol and DHEA must be in proper balance.

This blood test measures:

The cortisol test measures 'the stress hormone' cortisol which mobilises the body’s nutritional resources in stressful situations. Prolonged elevation of cortisol can cause fatigue, immune dysfunction, and impact sex hormones.

A long-acting adrenal hormone which regulates energy production, the immune system, brain chemistry, bone formation, muscle tone and libido. DHEA is converted by the body into testosterone and other sex hormones.

Thyroid Function

Your thyroid gland produces hormones that regulate growth and energy expenditure. Thyroid disorders are quite common, and many people don’t have any symptoms at all. This thyroid test screens for the thyroid hormones that play a key role in regulating the body’s metabolism.

This thyroid test measures:

Communicates with the thyroid gland to produce T3 and T4 which regulate metabolic functions. High TSH thyroid test levels indicates an underactive thyroid, and low levels an overactive thyroid.

Measures the thyroxine that is freely circulating and able to regulate metabolism. High FT4 thyroid test levels indicate an overactive thyroid, and low levels an underactive thyroid.

Measures the triiodothyronine that is freely circulating. High FT3 thyroid test levels indicate an overactive thyroid, and low levels an underactive thyroid.

Bone Health

Calcium and vitamin D play a critical role in maintaining bone health. When you don’t get enough calcium, you increase your risk of developing osteoporosis and stress fractures. This blood test measures your total and corrected calcium levels, your vitamin D levels, and also checks for gout.

This blood test measures:

Plays a critical role in developing and maintaining your overall bone health. If the total calcium result is abnormal, a corrected calcium calculation provides further information.

Although called a vitamin, vitamin D (25-OHD) is actually a steroid hormone which is activated by sunshine on the skin. It is essential for bone strength as it helps the intestines absorb calcium.

If too much urate is produced or not enough is excreted, it can accumulate and lead to gout – an inflammation that occurs in joints.

Most phosphate in the body comes from foods such as beans, peas and nuts, cereals, dairy products, eggs, beef, chicken and fish contain small amounts of phosphate. Phosphates are vital for energy production, muscle and nerve function, and bone growth.

Iron

This simple iron test measures how much ferritin you have stored in your body. This test can be used to diagnose anaemia or monitor an existing iron deficiency. This iron test can also be used to investigate iron overload syndrome (haemochromatosis) which is an inherited condition where your body cannot remove excess iron.

This blood test measures:

The ferritin concentration within the blood stream reflects the amount of iron stored in your body and is reduced in anaemia.

Active Vitamin B12

Vitamin B12 is an essential vitamin found in meat products and certain algae such as seaweed. It helps maintain healthy nerve cells and red blood cells and is also needed to make DNA, the genetic material in all cells. Both high and low vitamin B12 blood test levels may indicate an underlying problem. Low levels can suggest anaemia, a parasite or hyperthyroidism, whilst high levels can be a sign of liver disease, diabetes or kidney failure.

This vitamin B12 blood test measures:

Holotranscobalamin represents only 10-30% of the Vitamin B12 circulating in the blood but is the ONLY form of Vitamin B12 that is taken up and used by cells of the body, hence it’s other name - ACTIVE Vitamin B12.

Cholesterol

Lipids and cholesterol are fat-like substances in your blood. Some are necessary for good health, but when you have a high level of cholesterol in your blood, a lot of it ends up being deposited in the walls of your arteries and other vital organs. Lifestyle choices including diet, exercise and alcohol intake can all influence cholesterol levels and your risk of developing heart disease.

This cholesterol test measures:

High total cholesterol is a risk factor for cardiovascular disease.

LDL (low density lipoprotein) cholesterol is often called ‘bad cholesterol’ because it contributes to plaque, a thick, hard deposit that can clog arteries and make them less flexible.

HDL (high density lipoprotein) cholesterol is often called ‘good cholesterol’ and is protective against atherosclerosis.

The main storage form of fatty acids in the body. Elevated triglyceride levels may contribute to hardening of the arteries, and increase the risk of heart disease or stroke.

Non-HDL cholesterol is considered an effective lipid measurement for assessing cardiovascular disease risk as it is believed to reflect levels of 'bad' cholesterol. Other risk factors include smoking, high blood pressure, diabetes, obesity, physical inactivity, age, gender, ethnicity and family history.

Metabolic

Insulin resistance can lead to difficulty losing weight, distinct abdominal fat, fatigue, bloating and sugar cravings. Identifying insulin resistance early and committing to lifestyle changes can ultimately help the progression to diabetes.

This blood test measures:

If you have diabetes your body doesn't process glucose effectively.

The diabetes test counts the number of red blood cells that are glycosylated (attached to sugar) and reports it as a percentage, e.g. if 7 out of every 100 red blood cells are attached to sugar, the HbA1c result will be 7%.

A hormone produced by the pancreas that helps to control blood glucose levels and plays a role in controlling the levels of carbohydrates and fats stored in the body.

Full Blood Count

A full blood count provides a good snapshot of overall health and screens for a variety of disorders. It is used to assess immune function, infection, and anaemia, as well as nutritional status and exposure to toxic substances.

This blood test measures:

Responsible for carrying oxygen around the body. A high count can increase the risk of heart attack or stroke, whilst a low count can mean your body isn’t getting the oxygen it needs.

Responsible for fighting infection. A high count can indicate recent infection and even stress, whilst a low count can result from vitamin deficiencies, liver disease and immune diseases.

Responsible for blood clotting and healing. A high count can indicate a risk of thrombosis, whilst a low count can lead to easy bruising.

A good measure of your blood's ability to carry oxygen throughout your body. Elevated haemoglobin can be an indicator of lung disease, whilst a low result indicates anaemia.

A measure of the percentage of red blood cells in the total blood volume. Elevated haematocrit can increase the risk of heart attack or stroke.

Liver Function

Your liver processes drugs and alcohol, filters toxic chemicals, stores vitamins and minerals, and makes bile, proteins and enzymes. This liver function test examines enzymes and other markers for evidence of damage to your liver cells or a blockage near your liver which can impair its function.

This liver function test measures:

Removed from the body by the liver, and elevated levels may indicate liver disease.

Alkaline phosphatase (ALP) is an enzyme located mainly in the liver and the bones. High levels can indicate liver disease.

Aspartate aminotransferase (AST) is an enzyme created mainly by the liver and the heart. High levels can indicate damage to your liver caused by alcohol, drugs or hepatitis.

Alanine aminotransferase (ALT) is an enzyme mainly produced by the liver. A good indicator of liver damage caused by alcohol, drugs or hepatitis.

Gamma-glutamyl transferase (GGT) is a liver enzyme which can be used to diagnose alcohol abuse as it is typically raised in long term drinkers.

Albumin is a protein which keeps fluid from leaking out of blood vessels, nourishes tissues, and carries hormones, vitamins, drugs, and ions like calcium throughout the body. Albumin is made in the liver and is sensitive to liver damage.

Kidney Function

Your kidneys filter waste from your body and regulate salts in your blood. They also produce hormones and vitamins that direct cell activities in many organs and help to control blood pressure. When the kidneys aren't working properly, waste products and fluid can build up to dangerous levels creating a life-threatening situation.

This kidney function test measures:

Helps regulate the water and electrolyte balance of your body, and is important in the function of your nerves and muscles. Too much sodium can indicate kidney disease.

Minor changes in serum potassium ca have significant consequences. An abnormal concentration can alter the function of the nerves and muscles for example, the heart muscle may lose its ability to contract.

A high concentration of this waste product can indicate dehydration or that your kidneys aren’t working properly.

A waste molecule generated from muscle metabolism, and an accurate marker of kidney function.

The estimated glomerular filtration rate (eGFR) measures how well your kidneys filter the wastes from your blood and is the best overall measure of kidney function.

Inflammation

Inadequate recovery from exercise or overtraining can result in inflammation and muscle damage. In addition to c-reactive protein and creatine kinase, this panel also measures homocysteine which is another recognised risk factor for cardiovascular disease, as well as osteoporosis and Alzheimer’s.

This blood test measures:

When muscle cells are injured creatine kinase enzymes leak out of the cells and enter the bloodstream. Prolonged elevated creatine kinase after periods of rest can be a sign of overtraining.

A protein made by the liver and secreted into the blood. It is often the first evidence of inflammation - its concentration increases in the blood within a few hours after the start of inflammatory injury.

Only a small amount is usually detectable in the blood. However, when cells are damaged or destroyed, they release LD into the bloodstream, causing blood levels to rise.

An amino acid normally present in very small amounts in all cells of the body. Homocysteine is a product of methionine metabolism - one of the 11 ‘essential’ amino acids that must be derived from the diet.

Pancreatic Function

Proteins, fats, and carbohydrates are broken down by stomach acids, enzymes produced by the pancreas, and bile from the liver. This process also releases micronutrients. This blood test measures the levels of enzymes produced by the pancreas.

This blood test measures:

An enzyme produced by the pancreas which is released into the digestive tract to help digest fatty foods.

An enzyme made mainly by the pancreas which is released from the pancreas into the digestive tract to help digest starch in our food.

Test instructions

Visit the collection centre within one hour of waking for the most accurate hormone test measurements.

Fast from all food and drink other than water for at least 8 hours, and no more than 12 hours prior to your test.

Refrain from strenuous exercise for 2 days before your blood test as this can affect the results.

Take your form to your local collection centre to have your sample taken - no need for an appointment.

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